Population based studies have estimated the incidence of TBI but have not provided population-based estimates of subsequent disability. This population-based information is important for the appropriate planning and delivery of services to children disabled by TBI.[unreadable] Objectives: (1) Determine the incidence of mild, moderate, and severe TBI in children and adolescents 0-18[unreadable] years of age; (2) Determine the disability from different severities of TBI in children of different age groups;[unreadable] (3) Determine how this disability changes over time after injury; (4) Identify risk and protective factors for[unreadable] disability from TBI.[unreadable] Study Design: In this project, we will conduct a population-based surveillance of children and adolescents[unreadable] with TBI. From this surveillance, we will identify a sample of pediatric patients with TBI who will be recruited[unreadable] and enrolled in the study. This sample will be stratified by severity and age to allow adequate numbers of[unreadable] individuals at each severity level and each age group for study. Initial and base line measurements will be[unreadable] obtained, and patients will be followed over time to determine outcomes from TBI.[unreadable] Setting: Subjects will be identified in Emergency Departments, Hospitals and Medical Examiners in King[unreadable] County, Washington, and Philadelphia County, Pennsylvania.[unreadable] Participants: 1000 patients 0-18 years of age with mild, moderate or severe TBI.[unreadable] Outcome Measures: We will examine patient and family disability pre-injury and at 3, 12, 24, and 36 months[unreadable] post-TBl. This will include quality of life, social, emotional, behavioral and academic disability in patients and[unreadable] family functioning and parenting stress.[unreadable] Implications: This study will address many of these unanswered questions surrounding pediatric TBI. It will[unreadable] provide population-based rates of the incidence and disability fromTBI, including mild, moderate and severe[unreadable] based on medical record and interview data. It will follow patients and their families for three years after[unreadable] injury, examining the degree to which recovery plateaus in the months following TBI. It will examine factors[unreadable] which interact with the injury to produce disability, be they positive or negative influences on outcomes. The[unreadable] study team represents an interdisciplinary group of very experienced investigators to carry out a rigorous[unreadable] study to provide information to inform future research, care and policy.[unreadable]